The Mitral Valve Disease

Abstract

– The predominant cause of mitral stenosis is rheumatic heart disease.– The most frequent ECG abnormality with mitral stenosis is atrial fibrillation.– The occurrence of atrial fibrillation (or atrial flutter) in the patient with atrial fibrillation requires anticoagulationinitially by heparin followed by coumadin and often of treatment aiming at control of rapid ventricular response using digoxin,beta-blockade, and calcium-channel blockade.– Guidance by transesophageal echocardiography (TEE) is useful to rule out atrial thrombus before cardioversion.– Prolapse of the mitral valve is a fall below its normal position, and billowing (bulge beyond its normal place) of the mitralvalve is an abnormal movement of the mitral valve during systole beyond its normal position and into the left atrium.– Often mitral valve prolapse is a progressive disease with flail leaflets and chordal rupture being found in older patients.– Mitral insufficiency is an organic mechanism if there is intrinsic mitral valve disease or a functional mechanism if the valveis structurally normal but regurgitates due to an extravalvular abnormality.– Surgical correction of mitral regurgitation (MR) is indicated in patients with severe MR and symptoms or with reduced LV systolicfunction.– Prevention of infective endocarditis using the appropriate antibiotic prophylaxis is necessary in patients with MR.– The most frequent cause of mortality after surgical correction of MR is left ventricle dysfunction due to chronic irreversiblemyocardial damage.